SC_ 15-22_ Showalter

. , I'
Issued by WIRO SC15-22
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Deborah Showalter authorizing development in the Estuarine Shoreline Area of Environmental Concern
(AEC) at Lot 18, The Peninsula, in Surf City, Pender County as requested in the permittee's application package, dated
October 14, 2015, and received by DCM on October 27, 2015. This permit, issued on November 9, 2015, is subject to
compliance with the application and site drawing (where consistent with the permit), all applicable regulations and
special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment
or civil action, or may cause the permit to be null and void.
This permit authorizes: Construction of a single family residence with amenities and utilities.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s)dated received by DCM on October 27, 2015.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permittee or other qualified persons
within twenty (20)days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for
compliance. Any maintenance work or project modification not covered under LI Jason Dail
this permit,require further written permit approval.All work must cease when this CAMA LOCAL PERMIT OFFICIAL
permit expires on:
127 Cardinal Drive Extension
December 31,2018 Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to , j;• VED
another oartv without the written aooroval of the Division of Coastal tic, tf f 1 t L r NfTflN N

l
Name: Deborah Showalter
Minor Permit#SC15-22
Date: November 9, 2015
Page 2
(5) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetate and stabilized (planted and
mulched)within 14 days of construction completion.
(6) Any proposed for grading within the 30' buffer from the Normal High Water level must be contoured to prevent
additional stormwater runoff to the adjacent marsh and/or canal. This area shall be immediately vegetatively
stabilized, and must remain in a vegetated state.
(7) With exception of 200 sq. ft. or less of elevated, slatted, uncovered decking, no structures shall be located within the
30' Coastal Shoreline buffer, including but not limited to concrete slabs, stepping stones, roof covers, accessory
buildings, etc.
(8) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
•
SIGNATURE: 1 -11Y �?--)41 DATE: 7/. /0. /5f
PERMITTEE
RECEIVED
DCM WILMINGTON, NC

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i
OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
Locality C ( Permit Number minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
treatment system),Building,Electrical,Plumbing.Heating and Air Conditioning,Insulation and Energy Conservation,FiA
Ocean Hazard Estuarine Shoreline 1:7ORW Shoreline Public Trust Shoreline Other Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home ParkApproval,Highway Connection,and
(For official use only) others.Check with your IMal Permit Officer for more information.
GENERAL INFORMATION STATEMENT OF OWNERSHIP:
I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
LAND OWNER person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
Name Deborah Showalter listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
Address 2210 Lane Woods Dr.
City Columbus State Ohio Zip 43221 Phone [phone] Man owner or heecoordd title,Title is vested in Deborah eShowa Show563
alter
see Deed Book 4
pageCounty Registry
Email lmagnuson47®yahoo.eom Dan owner by virtue of inheritance.Applicant is an heir to the estate of
AUTHORIZED AGENT probate was in County.
Name Chris Barnes Df other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address 108 N.Stargazer Ct.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
City Hampstead State NC Zip 28443 Phone [phone] I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
Email [e-mail]
(Name) (Address)
l l) Peninsula at Topsail,LLC,P.O.Bow 3818,Mooresville,NC 28117(Lot 19 and Preservation areal
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the -----
adjacent waterbody.)Lot 18 Peninsula @ Topsail(Atkinson Rd.) Topsail Sound (2)
S r� ()
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) See Attached (4)
SIZE OF LOT/PARCEL: 8476 square feet •19 acres ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
PROPOSED USE:Residential® (Single-family Va Multi-family ) Commercial/Industrial 0 Other 0 may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies non and fioodproofrng techniques.
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level butrelated to this permit application.
excluding non-load-bearing attic space)
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This the 14 day of OCt 20 15
UPON SURFACES:1631 square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks,
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) QZe�
Landown r person author' to act as his/her agent for purpose of filing a CAMA permit application
STATE STORMIWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality? This application includes:general information(this form),a site drawing as described on the back of this application,the
YES I71 NC4 I ownership statement,the Ocean Hazard AEC Notice where necessary,a check for SI00.00 made payable to the locality,and
any information as may be provided orally by the applicant.The details of the application as described by these sources are
If yes,list the total built upon area/impervious surface allowed for your lot or parcel:1640 square feet. incorporated without reference in any permit which may be issued.Deviation from these details will constitute a violation of
any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
RECEIVED
DCM WILMINGTON, I
OCT 2 7 77,E

PAT MCCRORY
;a Governor
DONALD R. VAN DER VAART
Secretary
Environmental
Quality
November 9, 2015
Ms. Deborah Showalter
2201 Lane Woods Drive
Columbus, OH 43221
Dear Mr. Bell:
Attached is CAMA Minor Development Permit# SC 15-22 for work to be done at Lot 18, The Peninsula, in Surf
City, Pender County. A copy has been sent to your agent via email.
In order to validate this permit, please sign both copies of the permit as indicated for our records. Please retain
the orange copy for your files, sign the front and back pages of the white copy, and return to us within 20 days of
receipt in the enclosed, self-addressed envelope.
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Sincerely,
A,/y64,
•
\
Shaun K. Simpson
Permit Support Technician
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
Enclosures
Cc: WiRO files
�Nathing Compares_

Dail, Jason
From: Dail,Jason
Sent: Thursday, August 18, 2016 2:45 PM
To: '[e-mail]'
Cc: Steve Padgett ([e-mail]); Patti Arnold
([e-mail])
Subject: CAMA Minor permit amendments SC15-22 and SC16-10 - Showalter and Osborn - Lots
18 and 20, The Peninsula
Chris,
This email is to confirm that we received a request for permit modification to install retention walls around the
stormwater drainage swales between the subject properties. Due to the scope of work, in addition to the signed letters
of no objection from the neighboring property owners,the Division of Coastal Management has authorized the work
described in your request,dated received by DCM on 8/16/16.
If you have any questions, please feel free to give me a call.
Thank you,
jason
Jason Dail
Field Representative
NC Department of Environmental Quality
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
Phone:[phone], Fax:[phone]
[e-mail]
Nothing Compares,,,
E-mail correspondence to and from this address
may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS = TLIFT/BOOAATHOUSE)
I hereby certify that I own property adjacent to ,/ 6��`� ,s
' (Name of Property Owner)
property Iocated at
(Lot,Block,Road, etc.)
on , in ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: Mailing Address:
He has described to me, as shown below, the development he is proposing at that location, and,I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(15')from my area of riparian access unless
waived by me. If you wish to waive the setback,you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
2 L'0 / )16m r_5 24 J`c<<1f�'/E ki t,NA)tej,j,,0
Mailing Address Signature
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: /4.,-- 1/07 2
Address of Property: 20 /q /c s��c ?,& 4; S�f/C, j //'G d�y y-c
(Lot or Street#, Street or goad, City&County)
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Agent's Name#: C`r�S Mailing Address: ,3/6 / ,9-/Y/t -Alo,+t/
Agent's phone#: y'/C Z b/-91S-17? Cain,aSo.v /VC_ Z8 c/O3
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
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I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at th ww.nccoasta/rranarge►ment.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
(Property wner ormation) ((Adjacent Prope Owner Information) /6
Signature Signature
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Print or Type Name Print or Type Name
Mailing Address Mailing Address ‘,14
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CERTIFIED MAIL—RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERT W ER STATEMENT
I hereby certify that I own property adjacent to 0..."0,---51 _ _ 's
(Name of Property Owner)
property located at
,
(Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: Mailing Address:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fill in description below or attach a site drawing)
AUG 1,b 2016
i
aC W91.mINGIo , NG
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in writing
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.Wilmington,NC
DCM representatives can also be contacted at(910)796-7215.
No response is considered the same as no objection if you have been 'otified by Certified Mail
(Property Owner In io ) (Ripa ' "<r•perty Owner Information)
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Telephone Number ��-��� l4 � Telephone Number of /.S �3 E r
Date 7.4( 7( Date 2/4-4j
127 Cardinal Drive Ext.,Wilmington, North Carolina 28405-3845
Phone: [phone] FAX: [phone]\ IntPrnat• www nrrnastaimananamant mat

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C'I e."NI \ ' ( 'CAMA PERMIT
APPLIED FOR
. PROJECT:
Applicant proposes to construct a
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Pender County.
COMMENTS ACCEPTF n) THROUGHNovember , 2015
..._..._
APPLICANT: FOR MORE DETAILS CONTACT
, THE LOCAL PERMIT OFFICER BELOW:
Deborah Showalter - NC Div. of Coastal Management
2201 Lane Woods Dr_ 127 Cardinal Dr. Extension
,
Columbus, OH 43221 . ! Wilmington, NC 28405
Jason Dail, Field Representative
910-796-7221
SC 15-22 AGENT: Chris Barnes (9100 279-3158

Description of Project: (List all proposed construction and land disturbance.)Build
two story home with a look-out tower on pilings with a pervious driveway and
landscaping.
RECEIVED
DCM WILMINGTON,NC
OCT 2720131

U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Insurance Prog,an, Important: Read the instructions on pages 1-9. Expiration Date:July 31,2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name DEBORAH A.SHOWALTER Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number.
ATKINSON ROAD
City SURF CITY State NC ZIP Code 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 18,THE PENINSULA AT TOPSAIL,MAP BOOK 56 PAGE 39
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENtIAL
A5. Latitude/Longitude:Lat.34°24'56.4" Long.77.34'15.8"Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or endosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 1Q7 sq ft a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade 6 within 1.0 foot above adjacent grade NIA
c) Total net area of flood openings in AB.b 1 200 sq in c) Total net area of flood openings in A9.b was sq in
d) Engineered flood openings? ® Yes ❑ No d) Engineered flood openings? ❑ Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name 83.State
TOWN OF SURF CITY 370786 PENDER NC
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date 87,FIRM Panel 88.Flood 89.Base Flood Elevation(s)(Zone
3720423400 J 2/16/07 Effective/Revised Date Zone(s) AO,use base flood depth)
2/16/07 AE 9.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined El Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 Cl Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: ® Construction Drawings' 0 Building Under Construction' ❑ Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones A1-A30,AE,AN,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters.
Benchmark Utilized:USE 1-TB-2 Vertical Datum: NGVD 29
Indicate elevation datum used for the elevations in items a)through h)below. 0 NOVD 1929 ®NAVD 1988 0 Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 5.5 ®feet ❑meters
b)Top of the next higher floor 9.5 ®feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/.A 0 feet ❑meters
d)Attached garage(top of slab) jY.@ ❑feet 0 meters
e)Lowest elevation of machinery or equipment servicing the building 9.5 ®feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 3.2 ®feet ❑meters
g)Highest adjacent(finished)grade next to building(HAG) 3.9 ®feet ❑meters
h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 3.2 ®feet ❑meters
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ��iost•�••tMNH
information.I certify that the Information on this Certificate represents my best efforts to interpret the data available. ```�t%‘ N CAR is ,`,
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. �� �t .
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a i�40 • •'/G • -
❑ Check here if attachments. licensed land surveyor? ❑ Yes ® No i R /_ / I,
Certifier's Name PAUL TALBOT,PLS License Number L-4099 - `1 rr•�!/,
Title PRESIDENT Company Name TALBOT LAND SURVEYING,PC 1
Address 16747 U.S. 17,STE 118 City PSTEAD State NC ZIP Code 28443 �i�I .0•t`r
4
Signature `�c^�� 10/12/15 Telephone [phone] y'1r4, 0. 1t`100`�
-ECEIVED
FEMA Form 086-0-33(7/12) See reverse side for continuation. ReplacesiaCLUeiiii/ liiyiGiTWQN,NC

ELEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number:
ATKINSON ROAD
City SURF CITY State NC ZIP Code 28445 Company NAIC Number:
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
a Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. `•�. ' F"""i CA
Comments
Comments PROPOSED DWELLING ON PILINGS WITH ENCLOSURE UNDER ELEVATED FLOOR. .�� � ,....»,.i''U•�
SEAL
Signature Date 10/12/15 C
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND 2014, ' 710 .Jil*E)
>iri a aw4.0
For Zones AO and A(without BFE),complete Items E1-E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete sections A,B,
and C.For Items E1-E4,use natural grade,if available.Check the measurement used.In Puerto Rico only,enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is 0 feet ❑meters ❑above or 0 below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is 0 feet ❑meters 0 above or ❑below the HAG.
E3. Attached garage(top of slab)is 0 feet ❑meters 0 above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? 0 Yes ❑ No ❑ Unknown.The local official must certify this Information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
0 Check here if attachments.
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G
of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8-G10.In Puerto Rico only,enter meters.
G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.0 A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3.❑ The following information(Items GA-GI 0)is provided for community floodplain management purposes.
1.G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑New Construction 0 Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: 0 feet ❑meters Datum
G10.Community's design flodd elevation: 0 feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
•
Signature Date
•Comments i
❑Check here if attachments.
RECEIVED
FEMA Form 086-0-33(7/12) ReplaceA ►�(1�o0i�l@16�Ti41, NC

.ENDER; COMPLETE THIS SECTION COMPLETE THIS SECTION ON DEL/VERY
• Complete items 1,2,and 3. A. Signature
a Print your name and address on the reverse e CIAgent
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• Attach this card to the back of the mailpiece, B. R eived by(Printed Name) C. Date f Deli e.y
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1. Article Addressed to: D. Is delivery address different from Item 1? Ye
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delivery. USPS®-postmarked Certified Mail receipt to th
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signature)that is retained by the Postal Service' -Restricted delivery service,which provides
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with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear
certain Priority Mail items. USPS postmark.If you would like a postmark on
•For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mall item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
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You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
'S Form 3800.ADM 2015/Reverse)PSN 75an.n2.nnn_and,

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CERTIFIED MAIL° RECEIPT
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•A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
•A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
•Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to th
•A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service' -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
Important Reminders: -Adult signature service,which requires the
•You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service°, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whic
•Certified Mail service is not available for requires the signee to be at least 21 years of al
international mail. and provides delivery to the addressee specifie
•Insurance coverage is not available for purchase by name,or to the addressee's authorized agen
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mall service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear;
certain Priority Mail items. USPS postmark.If you would like a postmark on
■For an additiopal fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portior
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
'S Form 3800.April 2015 Reverse)PSN 7530-u2-000_511117

DENR CAMA Daily Check Log for WIRO
Date
Date Deposits Check Check Receipt or
Received d Check From(Name) Name of Permit Holder Vendor Number amount Permit Number/Comments Refund/Realloc,
10/20/2015 10/21/15 Dr.Jeff Morrison same First Citizens Bank 10494 $400.00 GP 66164D
— I 10/20/2015 10/23/15 Antinori Construction Inc Roger Lewis B of A 3890 $400.00 GP 64767D+GP 66165D@$200 JD rct.0303D
10/20/2015 10/21/15 Custom Island Homes by Ken Kiser LLC Ken Kiser I-CresCom Bank _ 3844 $400.00 major fee,7404 E.Beach Dr.01 BrCo PH rot.1134D
10/20/2015 10/21/15 Custom Island Homes by Ken Kiser LLC Ken Kiser iCresCom Bank 3845 $400.00 major fee,7406 E.Beach Dr.01 BrCo PH rct.1135D
10/20/2015 10/21/15 Custom Island Homes by Ken Kiser LLC Ken Kiser CresCom Bank _ 3846 $400.00 major fee,7408 E.Beach Dr.01 BrCo PH rct.1136D
10/20/2015 10/21/15 Custom Island Homes by Ken Kiser LLC Ken Kiser CresCom Bank 3847 $400.00 major fee,7410 E.Beach Dr.01 BrCo PH rct 1137D
10/21/2015 10/23/15 Money Order for Brandon Grimes Scott Pindell Wells Fargo Bank 59183420318 $400.00 GP 66167D©$600 _JD rct.0320D
10/21/2015 10/23/15 Money Order for Brandon Grimes Scott Pindell Wells Fargo Bank 59183420329 $200.00 GP 66167D©$600 JD rct.0320D
10/21/2015 10/23/15 Clements Marine Construction Inc Vern Hawkins First Citizens Bank 3933 $250.00 major fee,202 Kings Lnding Ct.Hamp PI PH rct.1138D
10/21/2015 10/23/15 Ocean's Edge Ventures LLC Margaret Ann Maida,LT BB&T 6777 $600.00 GP 66131 D HS rct 0980D
10/22/2015 10/23/15 TRCK same BB&T 1529 $100.00 renewal fee,MP 67-07 RM rct.0370D
10/22/2015 10/23/15 Town of North Topsail Beach _ same First Citizens Bank 40151 $400.00 GP 66110D IJD rct.0322D
10/22/2015 Allied Marine Contractors LLC_ Becky Olbrych �B of A 7923 $400.00 GP 64772D JD rct.0321 D
10/23/2015 Grice Construction Barry Wishon BB&T 10616 $400.00 GP 66132D HS rct.0981D
10/23/2015 Holden Docks and Bulkheads John Kozak CresCom Bank 2286 $200.00 GP 66135D HS rct 0983D
10/23/2015 JRW/RDW Inc Rick West 'First Bank 1180 $200.00 GP 66133D HS rct 0982D
10/23/2015 Live Oak Enterprises Inc(Future Homes) Larry Norris BB&T 35853 $100.00 minor fee,SC 15-21 PNCo JD rct.0323D
10/26/2015 HDI Holdings,LLC Robert Huff First South Bank 1017 $400.00 major fee,402 N.Lake,CB NHCo PH rot.1143D
10/26/2015 Clements Marine Construction Inc Jam Properties First Citizens Bank 3938 $400.00 GP 66180D+GP 66161D©$200 ea. RM rct.0371 D
10/26/2015 Live Oak Enterprises Inc(Future Homes) Dowell Gray Jr BB&T 35652 $100.00 minor fee,8708 3rd St NTB Ons PH rct 1139D
10/27/2015 ANA Builders Inc 'Karen Hartman First South Bank 8324 $100.00 minor fee,3693 Island Or.NTB Ons PH rct 1140D
10/27/2015 Charles Riggs&Assoc. Charles F.Riggs First Citizens Bank 14231 $100.00 minor fee,111 Topsail Rd,NTB Ons PH rct.1141 D
10/27/2015 David Lee Builders,Inc Warren Bell B of A 20389 $100.00 minor fee,410 Evelyn Ln.TB PN I PH rot 1142D
10/27/2015 CLB Custom Homes Inc. Deborah Showalter South State Bank 4785 $100.00 minor fee,Lot 18 The Peninsula,SC Pn PH mt.1144D